The present invention relates to piperazine substituted cyclohexane-1,4-diamine compounds of Formula (I) ##STR00001## and pharmaceutically acceptable forms thereof, as .alpha..sub.1a/.alpha..sub.1d adrenoreceptor modulators for the treatment of benign prostatic hypertrophy and lower urinary tract symptoms. The present invention also relates to pharmaceutical compositions comprising said new compounds, new processes to prepare these new compounds and new uses as a medicine as well as methods of treatment.

2. A compound selected from the group consisting of: 5-chloro-N-cis-{4-[4-(3-isopropoxy-pyridin-2-yl)-piperazin-1-yl]-cyclohex- yl}-2-methoxy-benzenesulfonamide, 5-chloro-2-fluoro-N-cis-{4-[4-(3-isopropoxy-pyridin-2-yl)-piperazin-1-yl]--cyclohexyl}-benzenesulfonamide, 5-chloro-N-cis-{4-[4-(3-cyclopropylmethoxy-pyridin-2-yl)-piperazin-1-yl]-- cyclohexyl}-2-methoxy-benzenesulfonamide, and 5-chloro-N-cis-{4-[4-(3-cyclopropylmethoxy-pyridin-2-yl)-piperazin-1-yl]--cyclohexyl}-2-fluoro-benzenesulfonamide.

3. A pharmaceutical composition, comprising a therapeutically effective amount of a compound according to claim 2 and a pharmaceutically acceptable carrier.

Description:

FIELD OF THE INVENTION

The present invention relates to new compounds, more particularly new piperazine substituted cyclohexane-1,4-diamines as selective .alpha..sub.1a/.alpha..sub.1d adrenoreceptor modulators for the treatment of benign prostatic hypertrophy and/orlower urinary tract symptoms. The present invention also relates to pharmaceutical compositions comprising said new compounds, new processes to prepare these new compounds, to the use of these compounds as .alpha..sub.1a/.alpha..sub.1d adrenoreceptormodulators and new uses as a medicine as well as methods of treatment.

RELATED ART

The adrenergic receptors (ARs), through which norepinephrine and epinephrine exert their biological activities, are targets for many therapeutically important drugs. The .alpha..sub.1-ARs play a dominant role in control of smooth musclecontraction and are important in control of blood pressure, nasal congestion, prostate function, and other processes (Harrison et al., Trends Pharmacol Sci; 1991; 62-67). The .alpha..sub.1-ARs were originally classified by pharmacological profiling intotwo subtypes, .alpha..sub.1a and .alpha..sub.1b (Morrow and Creese, Mol. Pharmacol; 1986; 29: 231-330; Minneman et al., Mol. Pharmacol; 1988; 33:509-514). Three genes encoding different .alpha..sub.1-AR subtypes (.alpha..sub.1a, .alpha..sub.1b, and.alpha..sub.1d) have been cloned for a number of species, including human (Schwinn et al., J. Biol Chem; 1990; 265: 8183-8189; Ramarao et al., J Biol Chem; 1992; 267:21936-21945; Bruno et al., Biochem Biophys Res Commun; 1991; 179: 1485-1490). Thesethree cloned .alpha..sub.1-ARs are best differentiated from one another on the basis of the relative binding affinities of a series of antagonist compounds. There is general agreement that the .alpha..sub.1a- and .alpha..sub.1b-ARs correspond to thepharmacologically defmed .alpha..sub.1a- and .alpha..sub.1b-ARs, while the functional role of the .alpha..sub.1d-AR is less clear, although it appears to mediate contraction of certain blood vessels (Goetz et al., Eur J Pharmacol; 1991; 272:R5-R6). Likeother ARs, the .alpha..sub.1-ARs are members of the G-protein coupled receptor super family, and in most cells the primary functional response to activation of all .alpha..sub.1-AR subtypes is an increase in intracellular Ca.sup.2+.

Benign prostatic hyperplasia (BPH) is a non-malignant enlargement of the prostate and is the cause of lower urinary tract symptoms (LUTS) in a large segment of the elderly male population. Symptoms such as straining, hesitancy, dribbling, weakstream, and incomplete emptying are classified as voiding or obstructive symptoms. Obstructive symptoms are primarily due to pressure upon the urethra from the physical mass of the enlarged prostate gland (the static component) and the increased tone ofthe smooth muscle of the prostate stroma and bladder neck (the dynamic component) (Caine, J Urol; 1986; 136: 1-4). Irritative or storage symptoms associated with BPH are frequency, urgency, nocturia, dysuria, and burning sensation. Patients feel thatthese symptoms are more disturbing than the obstructive symptoms. As the urine flow is reduced, due to the bladder outlet obstruction, the wall around the bladder base thickens and becomes hyperactive.

Functional studies have established that prostate smooth muscle tone is maintained through .alpha..sub.1-ARs and that these receptors mediate the dynamic component of obstruction. .alpha..sub.1-AR antagonists have successfully been used to treatthe obstructive symptoms associated with BPH (Jardin et al., Scientific Communications Int; 1998; pp 559-632). Furthermore, the .alpha..sub.1a-AR subtype comprises the majority of .alpha..sub.1-ARs in human prostatic smooth muscle and has been shown tomediate contraction in this tissue. Originally introduced as antihypertensive agents, .alpha..sub.1-AR antagonists have become increasingly important in the management of BPH. .alpha..sub.1-AR antagonists reduce smooth muscle tone in the prostate andlower urinary tract, thereby relaxing the bladder outlet and increasing urinary flow. The major disadvantage of non-selective .alpha..sub.1-blockers is their adverse effect profile, particularly vasodilatation leading to dizziness, postural hypotension,asthenia, and occasionally syncope. For this reason, it would be desirable to block .alpha..sub.1-ARs in the lower urinary tract without antagonizing the .alpha..sub.1-ARs responsible for maintaining vascular tone.

A number of factors can be involved in lower urinary tract symptoms. Adrenergic stimulation of the bladder results in relaxation due to .beta.-ARs, which dominate over contraction-mediating .alpha..sub.1-ARs. Bladder contraction is primarilymediated by muscarinic receptors. Some studies indicate that the contribution from .alpha..sub.1-ARs increases in hyperactive bladders due to bladder outlet obstruction or other conditions (Perlberg et al., Urology; 1982; 20:524-527); Restorick andMundy, Br J Urol; 1989; 63: 32-35). However another study finds no change in .alpha..sub.1-AR receptor function between normal and hypertrophic bladder due to outlet obstruction (Smith and Chapple, Neurolog Urodyn; 1994; 12: 414-415). It remainsunclear, which .alpha..sub.1-AR is dominant in the human bladder. One study reported a predominance of the .alpha..sub.1a subtype mRNA in the bladder dome, base, and trigone (Walden et al., J Urol; 1997; 157: 414-415). Another report found that the.alpha..sub.1d subtype is present as 66% of the .alpha..sub.1-ARs at both the mRNA and protein levels, while the .alpha..sub.1a subtype is present as 34% of the total, with no evidence of the .alpha..sub.1b subtype (Malloy et al., J Urol; 1998; 160:937-943). Drugs that selectively antagonize only the .alpha..sub.1a-AR subtype appear to have little effect upon the irritative symptoms of BPH. Ro-70004, a .alpha..sub.1a subtype-selective compound was reported to be discontinued in clinical studieswhen it was found to have poor efficacy in treating these symptoms (Blue et al., Abstract 5.sup.th International Consultation on BPH (Jun. 25-28) 2000). .alpha..sub.1d-ARs may be involved in mediating the irritative symptoms; however, the location ofthese .alpha..sub.1d-ARs is unknown (Piascik and Perez, J Pharmacol Exp Ther; 2001; 298: 403-410).

Studies have demonstrated Central Nervous Systems (CNS) inhibitory effects of .alpha..sub.1 antagonists upon the sympathetic and somatic outflow to the bladder in cats (Danuser and Thor, J Urol; 1995; 153: 1308-1312; Ramage and Wyllie, Eur JPharmacol; 1995; 294: 645-650). Intrathecally administered doxazosin caused a decrease in micturition pressure in both normal rats and rats with bladder hypertrophy secondary to outlet obstruction (Ishizuka et al., Br J Pharmacol; 1996; 117:962-966). These effects may be due to a reduction in parasympathetic nerve activity in the spinal cord and ganglia. Other studies used spontaneously hypertensive rats, which have overactive bladders, to demonstrate that .alpha..sub.1-AR antagonism only givenintrathecally caused a return to normal micturition (Persson et al., Am J Physiol; 1998; 275:R1366-1373, Steers et al. 1999; Exp Physiol; 84:137-147.). Antagonists administered intra-arterially near the bladder, or ablation of peripheral noradrenergicnerves, had no effect upon the bladder overactivity in these animals, indicating that .alpha..sub.1-ARs in the spinal cord control the bladder activity. Spinal .alpha..sub.1-ARs may be important targets for pharmacological treatment of BPH symptoms inhumans as well. All three .alpha..sub.1-AR subtype mRNAs are found throughout the human spinal cord, however the .alpha..sub.1d subtype MRNA is present at twice the level of the other subtypes, particularly in the ventral sacral motor neurons andautonomic parasympathetic pathways. (Stafford-Smith et al., Mol Brain Res; 1998; 63:234-261). There may be clinical advantages to the pharmacological blockade of the .alpha..sub.1d-ARs in the CNS in reducing BPH symptoms.

Antagonism of .alpha..sub.1d-ARs in the CNS and bladder may be an important activity in reducing the irritative or filling symptoms of BPH and improving patient symptom scores. Tamsulosin (Flomax.RTM., Yamanuchi and Boehringer Ingelheim) is a.alpha..sub.1-AR antagonist, which is about 15-fold selective for the .alpha..sub.1a and .alpha..sub.1d subtypes over the .alpha..sub.1b subtype. Large clinical trials of BPH patients with tamsulosin showed improvement in both obstructive and irritativesymptoms, however, cardiovascular and erectile dysfunction side effects were seen (Abrams et al. Br J Urol; 1995; 76:325-336; Chapple et al., Eur Urol; 1996; 29:155-167; Lepor, Urology; 1998; 51:892-900). Patients treated with non-selective.alpha..sub.1 antagonists also have improvement in both obstructive and irritative symptoms, although the risk of vascular side effects is greater. Generally, the .alpha..sub.1a subtype predominates in arteries at the mRNA and protein levels, while allthree subtypes are found in veins. The particular vessel bed is important in that the .alpha..sub.1a is the subtype found primarily in the splanchnic and coronary arteries, while the .alpha..sub.1d subtype is the predominant subtype found in the aorta. The .alpha..sub.1-AR subtypes in the vasculature have been found to change with age. Contraction of the mammary artery is mediated by both .alpha..sub.1a and .alpha..sub.1b subtypes. The number of .alpha..sub.1 receptors in the mammary artery doubleswith age; however, the .alpha..sub.1b subtype increases to a greater extent than the .alpha..sub.1a subtype (Raudner et al., Circulation; 1999; 100:2336-2343). The .alpha..sub.1b subtype may play a greater role in vascular tone in elderly patients. This suggests that an .alpha..sub.1a and .alpha..sub.1d-selective antagonist may have less effects upon the vasculature in elderly BPH patients, resulting in fewer cardiovascular side effects than are seen with non-selective .alpha..sub.1 antagonists,but provide relief from both obstructive and irritative symptoms.

A uroselective, cardiovascular-sparing .alpha..sub.1-AR antagonist would be expected to provide symptomatic relief of BPH comparable to currently marketed non-selective agents such as terazosin/Hytrin.RTM., doxazosin/Cardura.RTM.,alfuzosin/Xatral.RTM./Uroxatral.RTM. and weakly selective tamsulosin/Flomax.RTM./Harnal.RTM., without the undesirable side effects of postural hypotension, dizziness, and syncope. Ejaculatory dysfunction, or retrograde ejaculation, is a side effectseen in 10 to 35% of patients using tamsulosin (Lepor, Urology; 1998; 51:901-906; Andersson and Wyllie, Brit J Urol Int; 2003; 92:876-877). This activity has been attributed to tamsulosin antagonism at the 5-HT.sub.1a receptor. This often leads todiscontinuation of treatment. Furthermore, the non-selective .alpha..sub.1-AR antagonists and tamsulosin are contraindicated for use in conjunction with PDE inhibitors. There is likely to be high co-morbidity between LUTS and erectile dysfunctionpatients. Patients being treated for LUTS with the current .alpha..sub.1-AR blockers will find that they are excluded from using PDE inhibitors. An .alpha..sub.1-AR antagonist with a receptor subtype binding profile, which is selective for the.alpha..sub.1a and .alpha..sub.1d, subtypes, but with relatively little antagonism of the .alpha..sub.1b subtype may effectively treat both obstructive and irritative symptoms of BPH. Such a compound is likely to have a low cardiovascular side effectprofile and allow for use in conjunction with PDE inhibitors. Also low binding activity at the 5-HT.sub.1a receptor is likely to reduce the incidence of ejaculatory side effects.

LUTS also develop in women of a certain age. As in men, LUTS in women include both filling symptoms such as urgency, incontinence and nocturnia, and voiding symptoms such as weak stream, hesitancy, incomplete bladder emptying and abdominalstraining. The presence of this condition both in men and women suggests that at least part of the aetiology may be similar in the two sexes.

Accordingly, there is a need to provide dual selective .alpha..sub.1a/.alpha..sub.1d adrenoreceptor modulator antagonists, in other words compounds that interact both with the .alpha..sub.1a or/and .alpha..sub.1d adrenoreceptor but do notinteract (or at least interact substantially less) with the .alpha..sub.1b adrenoreceptor. The compounds of this invention are believed to be more efficacious drugs mainly for BPH/LUTS patients, and at the same time these compounds should show lessunwanted side effects than the existing pharmaceuticals.

##STR00002## and pharmaceutically acceptable forms thereof, wherein R.sub.1 is selected from the group consisting of (1) aryl, (2) aryl-C.sub.1-8alkyl, (3) C.sub.3-8cycloalkyl, (4) C.sub.3-8cycloalkyl-C.sub.1-8alkyl, (5) heteroaryl, (6)heteroaryl-C.sub.1-8alkyl, (7) heterocyclyl, and (8) heterocyclyl-C.sub.1-8alkyl, wherein each aryl, C.sub.3-8cycloalkyl, heteroaryl and heterocyclyl is unsubstituted or substituted with one, two, three or four substituents independently selected fromthe group consisting of (i) C.sub.1-8alkyl, (ii) C.sub.1-8alkoxy, (iii) C.sub.1-8alkoxy-C.sub.1-8alkyl, (iv) halo-C.sub.1-8alkyl, (v) halo-C.sub.1-8alkoxy, (vi) hydroxy-C.sub.1-8alkyl, (vii) C.sub.1-8alkoxy-carbonyl, (viii) SO.sub.2 substituted with asubstituent selected from the group consisting of C.sub.1-8alkyl, C.sub.3-8cycloalkyl, aryl, heteroaryl, and heterocyclyl, (ix) amino unsubstituted or mono- or di-substituted with C.sub.1-8alkyl, (x) cyano, (xi) halogen, (xii) hydroxy, (xiii) nitro,(xiv) amino-C.sub.1-8alkyl unsubstituted or mono- or di-substituted on amino with C.sub.1-8alkyl, (xv) aryl-C.sub.1-8alkyl, (xvi) aryl-C.sub.1-8alkoxy, (xvii) heteroaryl-C.sub.1-8alkyl, (xviii) heterocyclyl-C.sub.1-8alkyl; (xix) C(O) substituted with asubstituent selected from the group consisting of hydrogen, C.sub.1-8alkyl, C.sub.3-8cycloalkyl, aryl, heteroaryl, and heterocyclyl, (xx) S(O) substituted with a substituent selected from the group consisting of C.sub.1-8alkyl, C.sub.3-8cycloalkyl, aryl,heteroaryl, and heterocyclyl, (xxi) C(O)N substituted on nitrogen with two substituents selected from the group consisting of hydrogen, C.sub.1-8alkyl, C.sub.3-8cycloalkyl, aryl, heteroaryl, and heterocyclyl, (xxii) SO.sub.2N substituted on nitrogen withtwo substituents selected from the group consisting of hydrogen, C.sub.1-8alkyl, C.sub.3-8cycloalkyl, aryl, heteroaryl, and heterocyclyl, (xxiii) NHSO.sub.2 substituted on sulfur with a substituent selected from the group consisting of C.sub.1-8alkyl,C.sub.3-8cycloalkyl, aryl, heteroaryl, and heterocyclyl, (xxiv) NHC(O) substituted on carbonyl with a substituent selected from the group consisting of hydrogen, C.sub.1-8alkyl, C.sub.3-8cycloalkyl, aryl, heteroaryl, and heterocyclyl, (xxv) NHSO.sub.2Nsubstituted on nitrogen with two substituents selected from the group consisting of hydrogen, C.sub.1-8alkyl, C.sub.3-8cycloalkyl, aryl, heteroaryl, and heterocyclyl, (xxvi) NHC(O)N substituted on nitrogen with two substituents selected from the groupconsisting of hydrogen, C.sub.1-8alkyl, C.sub.3-8cycloalkyl, aryl, heteroaryl, and heterocyclyl, (xxvii) C.sub.3-8cycloalkyl, (xxviii) aryl, (xxix) heteroaryl, and (xxx) heterocyclyl; R.sub.2 is selected from the group consisting of hydrogen andC.sub.1-8alkyl; R.sub.3 is zero, one, two, three or four substituents independently selected from the group consisting of (1) C.sub.1-8alkyl, (2) C.sub.1-8alkoxy, (3) C.sub.1-8alkoxy-C.sub.1-8alkyl, (4) halo-C.sub.1-8alkyl, (5) halo-C.sub.1-8alkoxy, (6)hydroxy-C.sub.1-8alkyl, (7) C.sub.1-8alkoxy-carbonyl, (8) SO.sub.2 substituted with a substituent selected from the group consisting of C.sub.1-8alkyl, C.sub.3-8cycloalkyl, aryl, heteroaryl, and heterocyclyl, (9) amino unsubstituted or mono- ordi-substituted with C.sub.1-8alkyl, (10) cyano, (11) halogen, (12) hydroxy, (13) nitro, (14) amino-C.sub.1-8alkyl unsubstituted or mono- or di-substituted on amino with C.sub.1-8alkyl, (15) aryl, (16) aryl-C.sub.1-8alkyl, (17) aryl-C.sub.1-8alkoxy, (18)C.sub.3-8cycloalkyl, (19) C.sub.3-8cycloalkyl-C.sub.1-8alkyl, (20) C.sub.3-8cycloalkyl-C.sub.1-8alkoxy, (21) heteroaryl, (22) heteroaryl-C.sub.1-8alkyl, (23) heterocyclyl, (24) heterocyclyl-C.sub.1-8alkyl, (25) C(O) substituted with a substituentselected from the group consisting of hydrogen, C.sub.1-8alkyl, C.sub.3-8cycloalkyl, aryl, heteroaryl, and heterocyclyl, (26) S(O) substituted with a substituent selected from the group consisting of C.sub.1-8alkyl, C.sub.3-8cycloalkyl, aryl, heteroaryl,and heterocyclyl, (27) SO.sub.2 substituted with a substituent selected from the group consisting of C.sub.1-8alkyl, C.sub.3-8cycloalkyl, aryl, heteroaryl, and heterocyclyl, (28) C(O)N substituted on nitrogen with two substituents selected from the groupconsisting of hydrogen, C.sub.1-8alkyl, C.sub.3-8cycloalkyl, aryl, heteroaryl, and heterocyclyl, (29) SO.sub.2N substituted on nitrogen with two substituents selected from the group consisting of hydrogen, C.sub.1-8alkyl, C.sub.3-8cycloalkyl, aryl,heteroaryl, and heterocyclyl, (30) NHSO.sub.2 substituted on sulfur with a substituent selected from the group consisting of C.sub.1-8alkyl, C.sub.3-8cycloalkyl, aryl, heteroaryl, and heterocyclyl, (31) NHC(O) substituted on carbonyl with a substituentselected from the group consisting of hydrogen, C.sub.1-8alkyl, C.sub.3-8cycloalkyl, aryl, heteroaryl, and heterocyclyl, (32) NHSO.sub.2N substituted on nitrogen with two substituents selected from the group consisting of hydrogen, C.sub.1-8alkyl,C.sub.3-8cycloalkyl, aryl, heteroaryl, and heterocyclyl, (33) NHC(O)N substituted on nitrogen with two substituents selected from the group consisting of hydrogen, C.sub.1-8alkyl, C.sub.3-8cycloalkyl, aryl, heteroaryl, and heterocyclyl, and (34)C.sub.3-8cycloalkoxy; wherein each aryl, C.sub.3-8cycloalkyl, heteroaryl and heterocyclyl is unsubstituted or substituted with one, two, three or four substituents independently selected from the group consisting of (i) C.sub.1-8alkyl, (ii)C.sub.1-8alkoxy, (iii) C.sub.1-8alkoxy-C.sub.1-8alkyl, (iv) halo-C.sub.1-8alkyl, (v) halo-C.sub.1-8alkoxy, (vi) hydroxy-C.sub.1-8alkyl, (vii) C.sub.1-8alkoxy-carbonyl, (viii) C.sub.1-8alkyl-sulfonyl, (ix) amino unsubstituted or mono- or di-substitutedwith C.sub.1-8alkyl, (x) cyano, (xi) halogen, (xii) hydroxy, (xiii) nitro, and (xiv) amino-C.sub.1-8alkyl unsubstituted or mono- or di-substituted on amino with C.sub.1-8alkyl; and R.sub.4 and R.sub.5 is each selected from hydrogen or is each one, two,three or four substituents independently selected from the group consisting of C.sub.1-8alkyl, C.sub.1-8alkoxy, amino, C.sub.1-8alkyl-amino, cyano, halogen, oxo and nitro.

Examples of the present invention include pharmaceutical compositions comprising a therapeutically effective amount of any of the compounds of Formula (I) described in the present application and a pharmaceutical acceptable carrier.

An example of the invention is a pharmaceutical composition made by combining any of the compounds of Formula (I) described in the present application and a pharmaceutically acceptable carrier.

Another illustration of the invention is a process for making a pharmaceutical composition comprising combining any of the compounds described in the present application and a pharmaceutically acceptable carrier.

It is an aspect of the present invention to provide .alpha..sub.1a/.alpha..sub.1d adrenoreceptor modulators, more specifically inhibitors thereof, more interestingly antagonists thereof. The compounds of the present invention are preferablyselective dual .alpha..sub.1a/.alpha..sub.1d adrenoceptor modulators, more specifically inhibitors thereof, more interestingly antagonists thereof.

In another aspect, the invention is directed to methods for preventing contractions of the prostate, bladder and other organs of the lower urinary tract without substantially affecting blood pressure, by administering a compound of Formula (I)described in the present application or a pharmaceutical form comprising it to a mammal (including a human) suffering from contractions of the bladder and other organs of the lower urinary tract in an amount effective for the particular use.

A further object of the present invention is a method of treatment of a patient suffering from Benign Prostatic Hyperplasia (BPH), the method comprising administering an effective amount of a compound of Formula (I) described in the presentapplication or a pharmaceutical form comprising it to a patient suffering from BPH.

A further object of the present invention is a method for the treatment of lower-urinary-tract-symptoms (LUTS), which include, but are not limited to, filling symptoms, urgency, incontinence and nocturia, as well as voiding problems such as weakstream, hesitancy, intermittency, incomplete bladder emptying and abdominal straining, the method comprising administering an effective amount of a compound of Formula (I) described in the present application or a pharmaceutical form comprising it to apatient in need of such treatment.

A further object of the present invention is the use of these compounds as a medicine.

Yet another object of the present invention is the use of a compound of the present invention for the manufacture of a medicament for treating BPH and/or LUTS.

Still another object of the present invention is a method for treating of BPH and/or LUTS, the method comprising administering a therapeutically effective amount of a compound of the present invention in combination with an effective amount of a5.alpha.-reductase agent, such as, for example, finasteride or durasteride.

Still another object of the present invention is method for treating of BPH and/or LUTS, the method comprising administering a therapeutically effective amount of a compound of the present invention in combination with a therapeutically effectiveamount of a NK-1 inhibitor.

It is still another object of the present invention to provide methods for treating of BPH and/or LUTS, the method comprising administering an therapeutically effective amount of a compound of the present invention in combination with atherapeutically effective amount of anti-antiandrogens, androgen receptor antagonists, selective androgen receptor modulators, a PDE inhibitor, urinary incontinence drugs (e.g. anti-muscarinics) or 5HT-receptor modulators.

DETAILED DESCRIPTION OFTHE INVENTION

It should be understood that all compounds described and listed herein are meant to include all hydrates, solvates, polymorphs and pharmaceutically acceptable salts thereof. It should also be understood that unless otherwise indicated compoundsof Formula (I) are meant to comprise the stereochemically isomeric forms thereof.

An example of the present invention includes a compound of Formula (I) and pharmaceutically acceptable forms thereof, wherein R.sub.1 is aryl unsubstituted or substituted with one, two, three or four substituents independently selected from thegroup consisting of (i) C.sub.1-8alkyl, (ii) C.sub.1-8alkoxy, (iii) halo-C.sub.1-8alkoxy, and (iv) halogen.

An example of the present invention includes a compound of Formula (I) and pharmaceutically acceptable forms thereof, wherein R.sub.1 is aryl unsubstituted or substituted with one, two, three or four substituents independently selected from thegroup consisting of C.sub.1-8alkoxy and halogen.

An example of the present invention includes a compound of Formula (I) and pharmaceutically acceptable forms thereof, wherein R.sub.2 is hydrogen.

An example of the present invention includes a compound of Formula (I) and pharmaceutically acceptable forms thereof, wherein R.sub.3 is zero, one, two, three or four substituents independently selected from the group consisting of (1)C.sub.1-8alkyl, (2) C.sub.1-8alkoxy, (3) halo-C.sub.1-8alkoxy, and (4) C.sub.3-8cycloalkyl-C.sub.1-8alkoxy.

An example of the present invention includes a compound of Formula (I) and pharmaceutically acceptable forms thereof, wherein R.sub.3 is zero, one, two, three or four substituents independently selected from the group consisting ofC.sub.1-8alkoxy and C.sub.3-8cycloalkyl-C.sub.1-8alkoxy.

An example of the present invention includes a compound of Formula (I) and pharmaceutically acceptable forms thereof, wherein R.sub.4 and R.sub.5 is each hydrogen.

An example of the present invention includes a compound of Formula (I) selected from a compound of Formula (Ia):

An example of the present invention includes a compound of Formula (Ia) and pharmaceutically acceptable forms thereof, wherein R.sub.1 is selected from 3,4-(OCH.sub.3).sub.2-phenyl, 5-Cl-2-OCH.sub.3-phenyl and 5-Cl-2-F-phenyl; and R.sub.3 isselected from 3-OCH.sub.2-cyclopropyl and 3-OCH(CH.sub.3).sub.2.

An example of the present invention includes a compound of Formula (I) selected from a compound of Formula (Ib):

An example of the present invention includes a compound of Formula (Ib) and pharmaceutically acceptable forms thereof, wherein R.sub.1 is selected from 3,4-(OCH.sub.3).sub.2-phenyl, 5-Cl-2-OCH.sub.3-phenyl and 5-Cl-2-F-phenyl; and R.sub.3 isselected from 3-OCH.sub.2-cyclopropyl and 3-OCH(CH.sub.3).sub.2.

Another example of the present invention includes a compound selected from the group consisting of

The term "form" means, in reference to compounds of the present invention, such may exist as, without limitation, a salt, stereoisomer, tautomer, crystalline, polymorph, amorphous, solvate, hydrate, ester, prodrug or metabolite form. The presentinvention encompasses all such compound forms and mixtures thereof.

The term "isolated form" means, in reference to compounds of the present invention, such may exist in an essentially pure state such as, without limitation, an enantiomer, a racemic mixture, a geometric isomer (such as a cis or transstereoisomer), a mixture of geometric isomers, and the like. The present invention encompasses all such compound forms and mixtures thereof.

Certain compounds of Formula (I) may exist in various stereoisomeric or tautomeric forms and mixtures thereof. The invention encompasses all such compounds, including active compounds in the form of essentially pure enantiomers, racemic mixturesand tautomers.

The compounds of the present invention may be present in the form of pharmaceutically acceptable salts. For use in medicines, the "pharmaceutically acceptable salts" of the compounds of this invention refer to non-toxic acidic/anionic orbasic/cationic salt forms.

Suitable pharmaceutically acceptable salts of the compounds of this invention include acid addition salts which may, for example, be formed by mixing a solution of the compound according to the invention with a solution of a pharmaceuticallyacceptable acid such as hydrochloric acid, sulphuric acid, fumaric acid, maleic acid, succinic acid, acetic acid, benzoic acid, citric acid, tartaric acid, carbonic acid or phosphoric acid.

The invention includes compounds of various isomers and mixtures thereof. The term "isomer" refers to compounds that have the same composition and molecular weight but differ in physical and/or chemical properties. Such substances have the samenumber and kind of atoms but differ in structure. The structural difference may be in constitution (geometric isomers) or in an ability to rotate the plane of polarized light (stereoisomers).

The term "optical isomer" means isomers of identical constitution that differ only in the spatial arrangement of their groups. Optical isomers rotate the plane of polarized light in different directions. The term "optical activity" means thedegree to which an optical isomer rotates the plane of polarized light.

The term "racemate" or "racemic mixture" means an equimolar mixture of two enantiomeric species, wherein each of the isolated species rotates the plane of polarized light in the opposite direction such that the mixture is devoid of opticalactivity.

The term "enantiomer" means an isomer having a nonsuperimposable mirror image. The term "diastereomer" means stereoisomers that are not enantiomers.

The term "chiral" means a molecule which, in a given configuration, cannot be superimposed on its mirror image. This is in contrast to achiral molecules which can be superimposed on their mirror images.

The two distinct mirror image versions of the chiral molecule are also known as levo (left-handed), abbreviated L, or dextro (right handed), abbreviated D, depending on which way they rotate polarized light. The symbols "R" and "S" represent theconfiguration of groups around a stereogenic carbon atom(s).

An isolated form of a chiral or achiral-mixture means those forms that are substantially free of one mirror image molecule. Such substantially pure forms include those wherein one mirror image is present in a range of less than 25% in themixture, of less than 10%, of less than 5%, of less than 2% or less than 1%.

An example of an enantiomerically enriched form isolated from a racemic form of an achiral mixture includes a dextrorotatory enantiomer, wherein the mixture is substantially free of the levorotatory isomer. In this context, substantially freemeans the levorotatory isomer may, in a range, comprise less than 25% of the mixture, less than 10%, less than 5%, less than 2% or less than 1% of the mixture according to the formula:

Similarly, an example of an enantiomerically enriched form isolated from a racemic form of an achiral mixture includes a levorotatory enantiomer, wherein the mixture is substantially free of the dextrorotatory isomer. In this context,substantially free means the dextrorotatory isomer may, in a range, comprise less than 25% of the mixture, less than 10%, less than 5%, less than 2% or less than 1% of the mixture according to the formula:

"Geometric isomer" means isomers that differ in the orientation of substituent atoms in relationship to a carbon-carbon double bond, to a cycloalkyl ring, or to a bridged bicyclic system. Substituent atoms (other than hydrogen) on each side of acarbon-carbon double bond may be in an E or Z configuration. In the "E" configuration, the substituents are on opposite sides in relationship to the carbon-carbon double bond. In the "Z" configuration, the substituents are oriented on the same side inrelationship to the carbon-carbon double bond.

Substituent atoms (other than hydrogen) attached to a ring system may be in a cis or trans configuration. In the "cis" configuration, the substituents are on the same side in relationship to the plane of the ring; in the "trans" configuration,the substituents are on opposite sides in relationship to the plane of the ring. Compounds having a mixture of "cis" and "trans" species are designated "cis/trans".

The isomeric descriptors ("R," "S," "E," and "Z") indicate atom configurations relative to a core molecule and are intended to be used as defined in the literature.

Furthermore, compounds of the present invention may have at least one crystalline, polymorph or amorphous form. The plurality of such forms are included in the scope of the invention. In addition, some of the compounds may form solvates withwater (i.e., hydrates) or common organic solvents (e.g., organic esters such as ethanolate and the like). The plurality of such solvates are also intended to be encompassed within the scope of this invention.

Chemical Nomenclature and Definitions

Bond lines drawn into a ring system from a substituent variable indicate that the substituent may be attached to any of the substitutable ring atoms.

As used herein, the following terms are intended to have the following meanings (additional definitions are provided where needed throughout the Specification). The definitions herein may specify that a chemical term has an indicated formula. The particular formula provided is not intended to limit the scope of the invention, but is provided as an illustration of the term. The scope of the per se definition of the term is intended to include the plurality of variations expected to beincluded by one of ordinary skill in the art.

The term "C.sub.1-8 alkyl," whether used alone or as part of a substituent group, means a straight or branched chain hydrocarbon alkyl radical or alkyldiyl linking group comprising from 1 to 8 carbon atoms, wherein the radical is derived by theremoval of one hydrogen atom from a single carbon atom and the alkyldiyl linking group is derived by the removal of one hydrogen atom from each of two carbon atoms in the chain, such as, for example methyl, ethyl, 1-propyl, 2-propyl, 1-butyl, 2-butyl,tertiary butyl, 1-pentyl, 2-pentyl, 3-pentyl, 1-hexyl, 2-hexyl, 3-hexyl, 1-heptyl, 2-heptyl, 3-heptyl, 1-octyl, 2-octyl, 3-octyl and the like. Examples include C.sub.1-8alkyl, C.sub.1-6alkyl and C.sub.1-4alkyl groups. Alkyl radicals or linking groupsmay be attached to a core molecule via a terminal carbon atom or via a carbon atom within the chain. Similarly, substituent variables may be attached to an alkyl linking group when allowed by available valences.

The term "C.sub.2-8alkenyl," whether used alone or as part of a substituent group, means a straight or branched chain hydrocarbon alkyl or alkyldiyl radical radical having at least one carbon-carbon double bond, whereby the double bond is derivedby the removal of one hydrogen atom from each of two adjacent carbon atoms of the alkyl radical. Atoms may be oriented about the double bond in either the cis (E) or trans (S) conformation. Typical alkenyl groups comprising from 2 to 8 carbon atoms,such as, for example, ethenyl, propenyl, allyl (2-propenyl), butenyl, pentenyl, hexenyl and the like. Examples include C.sub.2-4alkenyl groups.

The term "C.sub.2-8alkynyl" whether used alone or as part of a substituent group, means a straight or branched chain hydrocarbon alkyl or alkyldiyl radical radical having at least one carbon-carbon triple bond, whereby the triple bond is derivedby the removal of two hydrogen atoms from each of two adjacent carbon atoms of the alkyl radical. Typical alkynyl groups comprising from 2 to 8 carbon atoms, such as, for example, ethynyl, propynyl, butynyl, pentynyl, hexynyl and the like. Examplesinclude C.sub.2-4alkynyl groups.

The term "C.sub.1-8alkoxy," whether used alone or as part of a substituent group, refers to an alkyl or alkyldiyl radical attached through an oxygen linking atom, as in the formula: --O--C.sub.1-8alkyl. Typical alkoxy groups comprising from 1 to8 carbon atoms, such as, for example, methoxy, ethoxy, propoxy, butoxy, pentoxy, hexoxy, heptoxy, octoxy and the like. An alkoxy radical may be attached to a core molecule and further substituted where indicated. Examples include C.sub.1-8alkoxy orC.sub.1-4alkoxy groups.

The term "C.sub.3-12cycloalkyl," whether used alone or as part of a substituent group, refers to a saturated or partially unsaturated, monocyclic or polycyclic hydrocarbon ring system radical derived by the removal of one hydrogen atom from asingle ring carbon atom.

The term "C.sub.3-12cycloalkyl" also includes a C.sub.3-8cycloalkyl, C.sub.3-10cycloalkyl, C.sub.5-6cycloalkyl, C.sub.5-8cycloalkyl, C.sub.5-12cycloalkyl, C.sub.9-13cycloalkyl or benzofused-C.sub.3-12cycloalkyl ring system radical such as, forexample, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, cyclooctyl, 1H-indenyl, indanyl, 9H-fluorenyl, tetrahydro-naphthalenyl, acenaphthenyl, adamantanyl and the like. Examples include C.sub.3-8cycloalkyl, C.sub.5-8cycloalkyl,C.sub.3-10-locycloalkyl and the like. C.sub.3-12cycloalkyl radicals may be attached to a core molecule and further substituted on any atom when allowed by available valences.

The term "heterocyclyl," whether used alone or as part of a substituent group, refers to a saturated or partially unsaturated monocyclic or polycyclic ring radical derived by the removal of one hydrogen atom from a single carbon or nitrogen ringatom. Typical heterocyclyl radicals include 2H-pyrrole, 2-pyrrolinyl, 3-pyrrolinyl, pyrrolidinyl, 1,3-dioxolanyl, 2-imidazolinyl (also referred to as 4,5-dihydro-1H-imidazolyl), imidazolidinyl, 2-pyrazolinyl, pyrazolidinyl, tetrazolyl, tetrazolidinyl,piperidinyl, 1,4-dioxanyl, morpholinyl, 1,4-dithianyl, thiomorpholinyl, piperazinyl, azetidinyl, azepanyl, hexahydro-1,4-diazepinyl, hexahydro-1,4-oxazepanyl, tetrahydro-furanyl, tetrahydro-thienyl, tetrahydro-pyranyl, tetrahydro-pyridazinyl,1,3-benzodioxolyl (also referred to as benzo[1,3]dioxolyl), 2,3-dihydro-1,4-benzodioxinyl (also referred to as 2,3-dihydro-benzo[1,4]dioxinyl) and the like. Heterocyclyl radicals may be attached to a core molecule and further substituted on any atomwhen allowed by available valences.

The term "hetero" used as a prefix for a ring system refers to the replacement of at least one ring carbon atom with one or more heteroatoms independently selected from N, S, or O. Examples include rings wherein 1, 2, 3 or 4 ring members are anitrogen atom; or, 0, 1, 2 or 3 ring members are nitrogen atoms and 1 member is an oxygen or sulfur atom. When allowed by available valences, up to two adjacent ring members may be heteroatoms; wherein one heteroatom is nitrogen and the other is oneheteroatom selected from N, S or O.

The term "aryl," whether used alone or as part of a substituent group, refers to an aromatic monocyclic or polycyclic hydrocarbon ring radical derived by the removal of one hydrogen atom from a single carbon atom of the ring system. Typical arylradicals include phenyl, naphthalenyl, azulenyl, anthracenyl and the like. Aryl radicals may be attached to a core molecule and further substituted on any atom when allowed by available valences.

The term "aromatic" refers to a cycloalkylic hydrocarbon ring system having an unsaturated, conjugated .pi. electron system.

The term "heteroaryl," whether used alone or as part of a substituent group, refers to an heteroaromatic monocyclic or polycyclic hydrocarbon ring radical derived by the removal of one hydrogen atom from a single ring carbon atom of the ringsystem. Typical heteroaryl radicals include furyl, thienyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, triazolyl, thiadiazolyl, pyridinyl, pyridazinyl, pyrimidinyl, pyrazinyl, indolizinyl, indolyl,azaindolyl, isoindolyl, benzo[b]furyl, benzo[b]thienyl, indazolyl, azaindazolyl, benzimnidazolyl, benzthiazolyl, benzoxazolyl, benzisoxazolyl, benzothiadiazolyl, benzotriazolyl, purinyl, 4H-quinolizinyl, quinolinyl, isoquinolinyl, cinnolinyl,phthalzinyl, quinazolinyl, quinoxalinyl, 1,8-naphthyridinyl, pteridinyl and the like. Heteroaryl radicals may be attached to a core molecule and further substituted on any atom when allowed by available valences.

The term "C.sub.1-8alkoxy-C.sub.1-8alkyl" means a radical of the formula: --C.sub.1-8alkyl-O--C.sub.1-8alkyl.

The term "C.sub.1-8alkoxy-carbonyl" means a radical of the formula: --C(O)--O--C.sub.1-8alkyl.

The term "C.sub.1-8alkyl-amino" means a radical of the formula: --NH--C.sub.1-8alkyl or --N(C.sub.1-8alkyl).sub.2.

The term "C.sub.1-8alkyl-sulfonyl" means a radical of the formula: --SO.sub.2--C.sub.1-8alkyl.

The term "amino" means a radical of the formula: --NH.sub.2.

The term "amino-C.sub.1-8alkyl" means a radical of the formula: --C.sub.1-8alkyl-NH.sub.2.

The term "aryl-C.sub.1-8alkoxy" means a radical of the formula: --O--C.sub.1-8alkyl-aryl.

The term "aryl-C.sub.1-8alkyl" means a radical of the formula: --C.sub.1-8alkyl-aryl.

The term "C.sub.3-8cycloalkyl-C.sub.1-8alkoxy" means a radical of the formula: --O--C.sub.1-8alkyl-C.sub.3-8cycloalkyl.

The term "C.sub.3-8cycloalkyl-C.sub.1-8alkyl" means a radical of the formula: --C.sub.1-8alkyl-C.sub.3-8cycloalkyl.

The term "heterocyclyl-C.sub.1-8alkyl" means a radical of the formula: --C.sub.1-8alkyl-heterocyclyl.

The term "heteroaryl-C.sub.1-8alkyl" means a radical of the formula: --C.sub.1-8alkyl-heteroaryl.

The term "halogen" or "halo" means the group fluoro, chloro, bromo or iodo.

The term "halo-C.sub.1-8alkoxy" means a radical of the formula: --O--C.sub.1-8alkyl-(halo).sub.n, wherein one or more halogen atoms may be substituted on C.sub.1-8alkyl when allowed by available valences (wherein n represents that amount ofavailable valences based on the number of carbon atoms in the chain), and includes monofluoromethyl, difluoromethyl, trifluoromethyl, trifluoroethyl and the like.

The term "halo-C.sub.1-8alkyl" means a radical of the formula: --C.sub.1-8alkyl-(halo).sub.n, wherein one or more halogen atoms may be substituted on C.sub.1-8alkyl when allowed by available valences (wherein n represents that amount of availablevalences based on the number of carbon atoms in the chain), and includes monofluoromethyl, difluoromethyl, trifluoromethyl, trifluoroethyl and the like.

The term "hydroxy-C.sub.1-8alkyl" means a radical of the formula: --C.sub.1-8alkyl-hydroxy, wherein C.sub.1-8alkyl is substituted on one or more available carbon chain atoms with one or more hydroxy radicals when allowed by available valences.

The term "substituted," refers to a core molecule on which one or more hydrogen atoms have been replaced with one or more functional radical moieties. The number that is allowed by available valences limits the amount of substituents. Substitution is not limited to the core molecule, but may also occur on a substituent radical, whereby the substituent radical becomes a linking group.

The term "independently selected" refers to one or more substituents selected from a group of substituents variable group, wherein the selected substituents may be the same or different.

The term "dependently selected" refers to one or more substituents specified in an indicated combination of structure variables.

Therapeutic Use

The ability of compounds of the present invention to specifically bind to the .alpha..sub.1a as well as to the .alpha..sub.1d receptor makes them useful for the treatment of BPH. The specificity of binding of compounds showing affinity for the.alpha..sub.1a and the .alpha..sub.1d receptor is compared against the binding affinities to other types of alpha receptors.

An aspect of the present invention includes a compound of Formula (I) having an IC.sub.50 (50% inhibition concentration) against the activity of either or both the .alpha..sub.1a and/or .alpha..sub.1d adrenoreceptor in a range of about 25 .mu.Mor less, of about 10 .mu.M or less, of about 1 .mu.M or less, of about 0.5 .mu.M or less, of about 0.25 .mu.M or less or of about 0.1 .mu.M or less.

Another aspect of the present invention includes dual selective .alpha..sub.1a/.alpha..sub.1d adrenoreceptor antagonists for treating, ameliorating or preventing a plurality of .alpha..sub.1a and/or .alpha..sub.1d adrenoreceptor mediateddisorders or diseases.

The usefulness of a compound of the present invention or composition thereof as a dual selective .alpha..sub.1a/.alpha..sub.1d adrenoreceptor antagonist can be determined according to the methods disclosed herein. The scope of such use includesthe treatment of benign prostatic hypertrophy and/or lower urinary tract symptoms.

An aspect of the use for a compound of Formula (I) includes use of an instant compound as a marker, wherein the compound is labeled with a ligand such as a radioligand (selected from deuterium, tritium and the like).

The present invention is further directed to a method for treating, ameliorating or preventing an .alpha..sub.1a and/or .alpha..sub.1d adrenoreceptor mediated disorder or disease in a subject in need of such treatment, amelioration or preventioncomprising administering to the subject a therapeutically or prophylactically effective amount of a compound of Formula (I) or a form or composition thereof.

An aspect of the method of the present invention further includes treating Benign Prostatic Hyperplasia in a subject in need of such treatment comprising administering to the subject in need of such treatment a therapeutically effective amount ofa compound of Formula (I) or a form or composition thereof.

An aspect of the method of the present invention further includes treating Lower Urinary Tract Symptoms in a subject in need of such treatment comprising administering to the subject in need of such treatment a therapeutically effective amount ofa compound of Formula (I) or a form or composition thereof.

Another aspect of the method of the present invention further includes administering to the subject an effective amount of a compound of Formula (I) or composition thereof in the form of a medicament. Consequently, the invention encompasses theuse of the compound of Formula (I) as a medicament.

Accordingly, the present invention includes the use of a compound of Formula (I) for the manufacture of a medicament for treating any of the diseases, disorders or conditions mentioned in any of the foregoing methods.

The term ".alpha..sub.1a and/or .alpha..sub.1d adrenoreceptor mediated disorder or disease" means disorders or diseases such as, but not limited to, contractions of the prostate, bladder and other organs of the lower urinary tract with or withoutan effect on blood pressure. The scope of such use includes the treatment of BPH and/or LUTS.

The term "LUTS" means disorders or diseases such as, but not limited to, filling symptoms, urgency, incontinence and nocturia, as well as voiding problems such as weak stream, hesitancy, intermnittency, incomplete bladder emptying and abdominalstraining.

The present invention thereby includes a method for treating, ameliorating or preventing an .alpha..sub.1a and/or .alpha..sub.1d adrenoreceptor mediated disorder or disease in a patient in need thereof comprising administering to the patient aneffective amount of a compound of Formula (I) or pharmaceutical composition thereof.

The present invention thereby includes a method for treating, ameliorating or preventing BPH and/or LUTS in a patient in need of such treatment comprising administering to the patient an effective amount of a compound of Formula (I) orpharmaceutical composition thereof.

The term "patient" or "subject" means an animal, preferably a mammal, most preferably a human, which has been a patient or the object of treatment, prevention, observation or experiment.

The term "administering" is to be interpreted liberally in accordance with the methods of the present invention. Such methods include therapeutically or prophylactically administering an effective amount of a composition or medicament of thepresent invention at different times during the course of a therapy or concurrently in a combination form. Prophylactic administration can occur prior to the manifestation of symptoms characteristic of an .alpha..sub.1a and/or .alpha..sub.1dadrenoreceptor mediated disorder or disease such that the disorder or disease is treated, ameliorated, prevented or otherwise delayed in its progression. The methods of the present invention are further to be understood as embracing all therapeutic orprophylactic treatment regimens used by those skilled in the art.

The term "effective amount" refers to that amount of active compound or pharmaceutical agent that elicits the biological or medicinal response in a tissue system, animal or human, that is being sought by a researcher, veterinarian, medicaldoctor, or other clinician, which includes treating, ameliorating or preventing the symptoms of a syndrome, disorder or disease being treated.

The effective amount of a compound of Formula (I) exemplified in a method of the present invention is in a range of from about 0.001 mg/kg/day to about 300 mg/kg/day.

The term "medicament" refers to a product for use in treating, preventing or ameliorating a kinase mediated disease, disorder or condition.

In an example of the method for treating, ameliorating or preventing an .alpha..sub.1a-AR and .alpha..sub.1d-AR mediated disorder or disease described herein, the method includes treating a patient suffering from BPH and/or LUTS comprisingadministering to the patient an effective amount of a combination product comprising a compound of Formula (I) or pharmaceutical composition thereof in combination with a BPH and/or LUTS therapeutic agent.

With regard to the method for administering a combination product, the term "effective amount" means that amount of the compound of Formula (I) or pharmaceutical composition thereof in combination with that amount of the therapeutic agent whichhave been adjusted to treat, ameliorate or prevent the symptoms of a syndrome, disorder or disease being treated. An effective amount of a compound of Formula (I) is in a range of from about 0.0002 mg/kg to about 2000 mg/kg of body weight per day.

As those skilled in the art will appreciate, the dosages of the compound of Formula (I) or pharmaceutical composition thereof and the therapeutic agent may be independently optimized and combined to achieve a synergistic result wherein thepathology is reduced more than it would be if either agent were used alone. In accordance with the method of the present invention, the individual components of the combination can be administered separately at different times during the course oftherapy or concurrently in divided or single combination forms. The instant invention is therefore to be understood as embracing all such regimes of simultaneous or alternating treatment and the term "administering" is to be interpreted accordingly.

Wherein the present invention is directed to the administration of a combination of a compound of Formula (I) and another agent for the treatment of BPH, the terms "therapeutically effective amount" or "prophylactically effective amount" shallmean that amount of the combination of agents taken together so that the combined effect elicits the desired biological or medicinal response.

Representative compounds of the present invention exhibit high selectivity for the .alpha..sub.1a and .alpha..sub.1d adrenergic receptor. Moreover, representative compounds of the present invention show low to very low affinity for the.alpha..sub.1d receptor. As a consequence thereof, the compounds of the present invention are believed to lower the intraurethral pressure without the unwanted side effects.

These compounds can be administered in dosages effective to antagonize the .alpha..sub.1a and .alpha..sub.1d receptor where such treatment is needed, as in BHP.

Pharmaceutical Compositions

The present invention also has the objective of providing suitable topical, oral, systemic and parenteral pharmaceutical formulations for use in the novel methods of treatment of the present invention. The compositions containing compounds ofthis invention as the active ingredient for use in the specific antagonism of human .alpha..sub.1a adrenergic receptors can be administered in a wide variety of therapeutic dosage forms in conventional vehicles for systemic administration.

The present invention also provides pharmaceutical compositions comprising one or more compounds of this invention in association with a pharmaceutically acceptable carrier. Preferably these compositions are in unit dosage forms such as tablets,pills, capsules, powders, graules, sterile parenteral solutions or suspensions, metered aerosol or liquid sprays, drops, ampoules, autoinjector devices or suppositories; for oral, parenteral, intranasal, sublingual or rectal administration, or foradministration by inhalation or insufflation.

In solid compositions such as tablets, the principal active ingredient is mixed with a pharmaceutical carrier, e.g. conventional tableting ingredients such as corn starch, lactose, sucrose, sorbitol, talc, stearic acid, magnesium stearate,dicalcium phosphate or gums, and other pharmaceutical diluents, e.g. water, to form a solid preformulation composition containing a homogenous mixture of a compound of the present invention, or a pharmaceutically acceptable salt thereof. When referringto these preformulation compositions as homogeneous, it is meant that the active ingredient is dispersed evenly throughout the composition so that the composition may be readily subdivided into equally effective unit dosage forms such as tablets, pillsand capsules. This solid preformulation composition is then subdivided into unit dosage forms of the type described above containing from 0.1 to about 500 mg of the active ingredient of the present invention.

The tablets or pills of the novel composition can be coated or otherwise compounded to provide a dosage form affording the advantage of prolonged action. For example, the tablet or pill can comprise an inner dosage and an outer dosage component,the latter being in the form of an envelope over the former. An enteric layer can separate the two components. That enteric layer serves to resist disintegration in the stomach and permits the inner component to pass intact into the duodenum or to bedelayed in release. A variety of materials can be used for such enteric layers or coatings, such materials including a number of polymeric acids and mixtures of polymeric acids with such materials as shellac, cetyl alcohol and cellulose acetate.

The liquid forms in which the novel compositions of the present invention may be incorporated for administration orally or by injection include aqueous solutions, suitably flavoured syrups, aqueous or oil suspensions, and flavoured emulsions withedible oils such as cottonseed oil, sesame oil, coconut oil or peanut oil, as well as elixirs and similar pharmaceutical vehicles. Suitable dispersing or suspending agents for aqueous suspensions include synthetic and natural gums such as tragacanth,acacia, alginate, dextran, sodium carboxymethylcellulose, methylcellulose, polyvinyl-pyrrolidone or gelatin.

As used herein, the term "composition" is intended to encompass a product comprising the specified ingredients in the specified amounts, as well as any product which results, directly or indirectly, from combination of the specified ingredientsin the specified amounts.

An effective but non-toxic amount of the compound desired can be employed as a .alpha..sub.1a/.alpha..sub.1d antagonistic agent. Advantageously, compounds of the present invention may be administered in a single daily dose, or the total dailydosage may be administered in divided doses of two, three or four times daily. Furthermore, compounds for the present invention can be administered in intranasal form via topical use of suitable intranasal vehicles, or via transdermal routes, usingthose forms of transdermal skin patches well known to those of ordinary skill in that art. To be administered in the form of a transdermal delivery system, the dosage administration will, of course, be continuous rather than intermittent throughout thedosage regimen.

The dosage regimen utilizing the compounds of the present invention is selected in accordance with a variety of factors including type, species, age, weight, sex and medical condition of the patient; the severity of the condition to be treated;the route of administration; the renal and hepatic function of the patient; and the particular compound thereof employed. A physician or veterinarian of ordinary skill can readily determine and prescribe the effective amount of the drug required toprevent, counter or arrest the progress of the condition. Optimal precision in achieving concentration of drug within the range that yields efficacy without toxicity requires a regimen based on the kinetics of the drug's availability to target sites. This involves a consideration of the distribution, equilibrium and elimination of a drug.

Compounds of Formula (I) may be administered in any of the foregoing compositions and according to dosage regimens established in the art whenever inhibition of the human .alpha..sub.1a-AR or .alpha..sub.1a-AR is required. Such inhibitionincludes inhibition of the human .alpha..sub.1a-AR or .alpha..sub.1a-AR, selective inhibition of the human .alpha..sub.1a-AR or .alpha..sub.1a-AR, dual inhibition of the human .alpha..sub.1a-AR and .alpha..sub.1a-AR or selective, dual inhibition of thehuman .alpha..sub.1a-AR and .alpha..sub.1a-AR. The compounds of Formula (I) may be used alone at appropriate dosages defined by routine testing in order to obtain optimal antagonism of the human .alpha..sub.1a-AR or .alpha..sub.1d-AR while minimizingany potential toxicity.

The daily dosage of the products may be varied over a wide range from about 0.001 to about 3,000 mg per adult human per day. For oral administration, the compositions are preferably provided in the form of tablets containing 0.01, 0.05, 0.1,0.5, 1.0, 2.5, 5.0, 10.0, 15.0, 25.0, 50.0 and milligrams of the active ingredient for the symptomatic adjustment of the dosage to the patient to be treated. A medicament typically contains from about 0.01 mg to about 500 mg of the active ingredient,preferably, from about 0.001 mg to about 3000 mg of active ingredient.

An effective amount of a compound of Formula (I) is a dosage level range of from about 0.001 mg/kg to about 20 mg/kg of body weight per day. Preferably, the range is from about 0.001 to 10 mg/kg of body weight per day. More preferably, therange is from about 0.001 mg/kg to 7 mg/kg of body weight per day. The compounds may be administered on a regimen of 1 to 4 times per day.

Compounds of the present invention may be used alone at appropriate dosages defined by routine testing in order to obtain optimal antagonism of the human .alpha..sub.1a/.alpha..sub.1d adrenergic receptor while minimizing any potential toxicity. In addition, co-administration or sequential administration of other agents which alleviate the effects of BPH is desirable.

When compounds of Formula (I) are administered in a combination product, the compound of Formula (I) or pharmaceutical composition thereof and the therapeutic agent may be co-administered or sequentially administered whereby the effects of BPHand/or LUTS is treated, ameliorated or prevented.

Thus, in one embodiment, the method of the present invention includes administration of compounds of this invention and a human testosterone 5-.alpha. reductase inhibitor, including inhibitors of 5-.alpha. reductase isoenzyme 2.

The dosages of the .alpha..sub.1a adrenergic receptor and testosterone 5-.alpha. reductase inhibitors are adjusted when combined to achieve desired effects. As those skilled in the art will appreciate, dosages of the 5-.alpha. reductaseinhibitor and the .alpha..sub.1a adrenergic receptor antagonist may be independently optimized and combined to achieve a synergistic result wherein the pathology is reduced more than it would be if either agent were used alone. In accordance with themethod of the present invention, the individual components of the combination can be administered separately at different times during the course of therapy or concurrently in divided or single combination forms. The instant invention is therefore to beunderstood as embracing all such regimes of simultaneous or alternating treatment and the term "administering" is to be interpreted accordingly.

The effective amount of the therapeutic agent selected from a human testosterone 5.alpha.-reductase inhibitor agent or 5-.alpha. reductase isoenzyme 2 inhibitor agent (such as finasteride or durasteride and the like or mixtures thereof), a NK-1inhibitor, an anti-androgen receptor agonist, an androgen receptor antagonist, a selective androgen receptor modulators, a PDE inhibitor, a urinary incontinence drugs (e.g. anti-muscarinics) or a 5HT-receptor modulator is a dosage level range of fromabout 0.0002 mg/kg to about 20 mg/kg of body weight per day. Preferably, the range is from about 0.001 to 10 mg/kg of body weight per day. More preferably, the range is from about 0.001 mg/kg to 7 mg/kg of body weight per day.

For the treatment of benign prostatic hyperplasia, compounds of this invention exhibiting .alpha..sub.1a adrenergic receptor antagonism can be combined with a therapeutically effective amount of a 5.alpha.-reductase isoenzyme 2 inhibitor, such asfinasteride.

Thus, in one embodiment of the present invention, a method of treating BPH is provided which comprises administering to a subject in need of treatment any of the compounds of the present invention in combination with finasteride effective totreat BPH.

The dosage of finasteride administered to the subject is about 0.01 mg per subject per day to about 50 mg per subject per day in combination with an .alpha..sub.1a antagonist. Preferably, the dosage of finasteride in the combination is about 0.2mg per subject per day to about 10 mg per subject per day, more preferably, about 1 to about 7 mg per subject to day, most preferably, about 5 mg per subject per day.

In other embodiments of the present inventions, a method of treating BPH is provided which comprises administering to a subject in need of treatment any of the compounds of the present invention in combination with a therapeutically effectiveamount of an anti-antiandrogenic agent, androgen receptor antagonists, selective androgen receptor modulators, urinary incontinence drugs (e.g. anti-muscarinics) or 5HT-receptor modulators.

A representative compound of Formula (I) or a form thereof for use in the therapeutic methods and pharmaceutical compositions, medicines or medicaments described herein includes a compound selected from:5-chloro-N-cis-{4-[4-(3-isopropoxy-pyridin-2-yl)-piperazin-1-yl]-cyclohex- yl}-2-methoxy-benzenesulfonamide, 5-chloro-2-fluoro-N-cis-{4-[4-(3-isopropoxy-pyridin-2-yl)-piperazin-1-yl]- -cyclohexyl}-benzenesulfonamide,5-chloro-N-cis-{4-[4-(3-cyclopropylmethoxy-pyridin-2-yl)-piperazin-1-yl]-- cyclohexyl}-2-methoxy-benzenesulfonamide, and 5-chloro-N-cis-{4-[4-(3-cyclopropylmethoxy-pyridin-2-yl)-piperazin-1-yl]-- cyclohexyl}-2-fluoro-benzenesulfonamide. SyntheticMethods

Representative compounds of the present invention can be synthesized in accordance with the general synthetic schemes described below and are illustrated more particularly in the specific synthetic examples that follow. The general schemes andspecific examples are offered by way of illustration; the invention should not be construed as being limited by the chemical reactions and conditions expressed. The methods for preparing the various starting materials used in the schemes and examplesare well within the skill of persons versed in the art. No attempt has been made to optimize the yields obtained in any of the example reactions. One skilled in the art would know how to increase such yields through routine variations in reactiontimes, temperatures, solvents and/or reagents.

During any of the processes for preparation of the compounds of the present invention, it may be necessary and/or desirable to protect sensitive or reactive groups on any of the molecules concerned. This may be achieved by means of conventionalprotecting groups, such as those described in Protective Groups in Organic Chemistry, ed. J. F. W. McOmie, Plenum Press, 1973; and T. W. Greene & P. G. M. Wuts, Protective Groups in Organic Synthesis, 3rd Edition, John Wiley & Sons, 1999. Theprotecting groups may be removed at a convenient subsequent stage using methods known in the art.

Synthetic Routes

Where the processes for the preparation of the compounds according to the invention give rise to mixtures of stereoisomers, these isomers may be separated by conventional techniques such as preparative chromatography. The compounds may beprepared in racemic form, or individual enantiomers may be prepared either by enantiospecific synthesis or by resolution. The compounds may, for example, be resolved into their component enantiomers by standard techniques, such as the formation ofdiastereomeric pairs by salt formation with an optically active acid, such as (-)-di-p-toluoyl-D-tartaric acid and/or (+)-di-p-toluoyl-L-tartaric acid followed by fractional crystallization and regeneration of the free base. The compounds may also beresolved by formation of diastereomeric esters or amides, followed by chromatographic separation and removal of the chiral auxiliary. Alternatively, the compounds may be resolved using a chiral HPLC column.

The terms used in describing the invention are commonly used and known to those skilled in the art. Some reagents are referred to as a chemical formula. Other reagents are referred to as abbreviations known to persons skilled in the art. Whenused herein, the following abbreviations have the indicated meanings: Cpd compound DCM dichloromethane EtOAc ethyl acetate Et.sub.2O diethylether LCMS Liquid Chromatography Mass Spectrometry min/hr(s)/d(s) minute/hour(s)/day(s) MS Mass Spectrum in naz(M+H.sup.+) m/z mass/charge Ret. retention time RT/rt/r.t. room temperature TEA triethylamine THF tetrahydrofuran TLC Thin Layer Chromatography

Specific compounds which are representative of the invention may be prepared as per the following examples offered by way of illustration and not by way of limitation. No attempt has been made to optimize the yields obtained in any of thereactions. One skilled in the art would know bow to increase such yields through routine variations in reaction times, temperatures, solvents and/or reagents. Additional compounds may be made according to the synthetic methods of the present inventionby one skilled in the art, differing only in possible starting materials, reagents and conditions used in the instant methods.

##STR00010##

A R.sub.3 substituted pyridinyl Compound A1 (wherein X represents a halogen atom or other suitable leaving group) is dissolved in a solvent (such as DMF, dry THF or DCM and the like), then a R.sub.4 substituted piperazine-1-carboxylic acidtert-butyl ester Compound A2 and K.sub.2CO.sub.3 are added. The mixture is stirred and heated at 80.degree. C. for 2 hrs. The solvent is removed and the resulting residue is taken up in a solvent (such as Et.sub.2O and the like), then washed (such aswith H.sub.2O and the like) and dried (such as with Na.sub.2SO.sub.4 and the like). The solvent is evaporated from the dry solution to provide a substituted 4-pyridin-2-yl-piperazine-1-carboxylic acid tert-butyl ester Compound A3.

One or more of the R.sub.3 substituents for the Compound A1 starting material may be amenable for further substitution using various reagent(s) and reaction conditions, thus enabling the preparation of other compounds that are representative ofthe invention both as shown herein and further by one skilled in the art.

##STR00011##

Compound A3 is dissolved in a solvent (such as dry DCM and the like) and stirred with an acid (such as TFA and the like) at room temperature for 2.5 hrs. The solvent is evaporated to provide a residue which is taken up in a solvent (such as DCMand the like) and treated with a base (such as 1N NaOH and the like) to about pH 10. The organic layer is dried (such as with K.sub.2CO.sub.3 and the like). The solvent is evaporated from the dry solution to provide a substituted1-pyridin-2-yl-piperazine Compound A4 which is used directly in the next step without further purification.

##STR00012##

Compound A4, a R.sub.2 and R.sub.5 substituted (4-oxo-cyclohexyl)-carbamic acid tert-butyl ester Compound A5, a reducing agent (such as NaBH(OAc).sub.3 and the like), with or without a catalytic amount of an acid (such as HOAc and the like) and adry solvent (such as anhydrous DCM and the like) are mixed together at r.t. to form a slurry. The mixture is stirred under a nitrogen atmosphere until Compound A5 is no longer detected (using TLC and/or LCMS). The mixture is diluted with a solvent(such as DCM, AcOEt and the like), sequentially washed (with water, NaHCO.sub.3 or NH.sub.4Cl (saturated) and the like) and dried (such as over Na.sub.2SO.sub.4). The solvent is evaporated from the dry solution to produce a crude product which ispurified via flash chromatography (on a silica gel column, using AcOEt or an AcOEt/hexane mixture as eluent) to provide a substituted [4-(4-pyridin-2-yl-piperazin-1-yl)-cyclohexyl]-carbamic acid tert-butyl ester Compound A6 as a mixture (represented bywave bond lines) of cis and trans isomers.

##STR00013##

Compound A6 is dissolved in a solvent (such as DCM and the like) at r.t., then stirred into an acid (such as TFA and the like) and a catalytic amount of H.sub.2O is added. The mixture is stirred for 2 hrs, then the solvent is removed and theresulting residue is taken up in a solvent (such as DCM and the like) and treated with a base (such as 1N NaOH, 1N KOH and the like) to about pH 10. The organic layer is dried (such as with K.sub.2CO.sub.3, Na.sub.2SO.sub.4 and the like). The solventis evaporated from the dry solution to provide a substituted 4-(4-pyridin-2-yl-piperazin-1-yl)-cyclohexylamine Compound A7 as a crude product which is used in the next step without further purification.

##STR00014##

Compound A7 and an R.sub.1 substituted sulfonyl chloride Compound A8 are dissolved in a solvent (such as DCM and the like). A mild base such as K.sub.2CO.sub.3 is added and the solution is stirred at r.t. until Compound A7 is no longer detected(using TLC and/or LCMS). The mixture is filtered to provide a solution of a substituted 4-(4-pyridin-2-yl-piperazin-1-yl)-cyclohexyl-amino-sulfonyl Compound A9 as a cis and trans isomer mixture.

The substituents for Compound A6, Compound A7 or Compound A9 may be further substituted either before or after deprotection using various reaction materials, reagent(s) and conditions, thus enabling the preparation of other compounds that arerepresentative of the invention by one skilled in the art.

##STR00015##

The Compound A9 isomers, i.e., Compound A10 and Compound A11 are relatively polar and may be separated via chromatographic techniques such as preparative TLC (using an eluent mixture such as 5% MeOH/DCM and the like). A cis isomer such asCompound A10 is less polar and a trans isomer such as Compound A11 is more polar.

2-bromo-pyridin-3-ol Compound 1a (6.4 g, 36.8 mmol) was dissolved into DMF (100 mL), then bromomethyl-cyclopropane Compound 1b (5.0 g, 37 mmol) and K.sub.2CO.sub.3 (7.5 g, 54.3 mmol) were added. The mixture was stirred and heated at 80.degree. C. for 2 hrs. Excess DMF was removed on a rotary evaporator. The brown residue was mixed with Et.sub.2O (150 mL), then washed with H.sub.2O and dried over Na.sub.2SO.sub.4. The solvent was evaporated from the dry solution to provide2-bromo-3-cyclopropylmethoxy-pyridine Compound 1c (7.04 g, yield 84%).

##STR00017##

Compound 1c (2.3 g, 10 mmol) and piperazine-1-carboxylic acid tert-butyl ester Compound 1d (2.8 g, 15 mmol), CuCN (0.5 g) and K.sub.2CO.sub.3 (1.38 g, 10 mmol) were mixed and heated at 110.degree. C. in a sealed tube for 48 hrs. The brownmixture was cooled to room temperature, then dissolved into AcOEt and washed with H.sub.2O. The organic layer was dried over Na.sub.2SO.sub.4. The solvent was evaporated from the dry solution to provide a crude product as a brown oil which was purifiedvia flash column chromatography (silica gel, 25%-50% AcOEt/Hexane) to provide 4-(3-cyclopropylmethoxy-pyridin-2-yl)-piperazine-1-carboxylic acid tert-butyl ester Compound 1e (0.70 g, yield 21%) as a yellowish to almost colorless oil.

##STR00018##

Compound 1e (0.38 g) was dissolved into DCM and stirred with TFA (0.5 mL) at room temperature for 2.5 hrs. The volatiles were removed on a rotary evaporator to provide a residue which was mixed with DCM and treated with 1N NaOH to about pH 10. The organic layer was dried over K.sub.2CO.sub.3. The solvent was evaporated from the dry solution to provide 1-(3-cyclopropylmethoxy-pyridin-2-yl)-piperazine Compound 1f (0.176 g) as a yellowish oil which was used directly in the next step withoutfurther purification.

Compound 1h was dissolved into DCM and stirred with TFA and a catalytic amount of H.sub.2O at room temperature for 2 hrs. The volatiles were removed on a rotary evaporator to provide a residue which was mixed with DCM and treated with 1N NaOH toabout pH 10. The organic layer was dried over K.sub.2CO.sub.3. The solvent was evaporated from the dry solution to provide 4-[4-(3-cyclopropylmethoxy-pyridin-2-yl)-piperazin-1-yl]-cyclohex- ylamine, Compound 1i, (0.084 g) as a yellowish oil which wasused directly in the next step without further purification.

Membranes were prepared from COS-7 cells (African Green monkey kidney SV40-transformed cells) that had been transfected with one of the three .alpha..sub.1-AR subtypes (Genbank accession number for the .alpha..sub.1a subtype: AF013261; Genbankaccession number for the .alpha..sub.1b subtype: NM000679; Genbank accession number for the .alpha..sub.1d subtype: NM000678) using the following method: COS cells from ten 100 mm tissue culture plates were scraped into a 5 mL volume of TE (a mixture of50 mM Tris-HCl, 5 mM EDTA, pH 7.4). The cell suspension was disrupted with a Brinkman Polytron (at a setting of 8) for 10 sec. The disrupted cells were centrifuged at 1000.times.g for 10 min at 4.degree. C. Supernatants were centrifuged at34,500.times.g for 20 min at 4.degree. C. The membrane pellets were suspended in a 2 mL volume of TNE (a mixture of 50 mM Tris-HCl, 5 mM EDTA and 150 mM NaCl at pH 7.4). An aliquot of the membrane suspension was stored at -70.degree. C. until use. The protein concentration was determined using the BioRad "DC" protein assay kit following membrane solubilization with Triton X-100.

The ability of a test compound to relax prostatic smooth muscle tissue in vivo may be evaluated using the prostatic intraurethral pressure (IUP) and blood pressure (MAP) in the anesthetized canine model. Alternatively, the ability of a testcompound to relax prostate smooth muscle tissue in vivo may be evaluated by evaluating the prostatic intraurethral pressure (IUP) and blood pressure (MAP) in the conscious canine model.

It is to be understood that the preceding description teaches the principles of the present invention, with examples thereof, which have emphasized certain aspects. It will also be understood that the practice of the invention encompasses all ofthe usual variations, adaptations and modifications as come within the scope of the following claims and their equivalents. However, numerous other equivalents not specifically elaborated on or discussed may nevertheless fall within the spirit and scopeof the present invention and claims and are intended to be included.

Throughout this application, various publications are cited. The disclosure of all publications or patents cited herein are entirely incorporated herein by reference as they show the state of the art at the time of the present invention and/orto provide description and enablement of the present invention. Publications refer to any scientific or patent publications, or any other information available in any media format, including all recorded, electronic or printed formats.